DOI: 10.36347/sasjm.2023.v09i08.011

Pages: 860-864

Objectives: The aim of this article were to review usefulness of early clinical detection of UTI without lab tests as diagnostic tool for UTI in primary care and to describe when to start antibiotic treatment for management of UTI according to international guidelines. The emphasis of this review is uncomplicated UTI. Methods: A search was conducted on PubMed and official webpages of major urological, infectious diseases and general practice organisations to identify peer reviewed original articles and reviews, using the search terms ‘UTI’. I considered only papers written in English, with emphasis on more recent articles published up to July 2023. Results: There is a variation in recommendations between guidelines can be a source of confusion and controversy for clinicians in primary care. However, early detection and treatment, education of patients and removal of risk factors may reduce the number of symptomatic episodes, antibiotics usage and antimicrobial resistance in primary care. Conclusion: The diagnosis of acute uncomplicated cystitis in healthy women can be made with reasonable certainty by evaluation of symptoms and signs without a doctor’s visit or urine tests. Individualised assessment of risk factors and previous clinical history is needed to choose the most suitable antimicrobial treatment. Immediate antimicrobial therapy with Trimethoprim-sulfamethoxazole (160/800 mg twice daily for 3 days), Nitrofurantoin (100 mg twice daily for 5-7 days), or Fosfomycin (3g in a single dose) is indicated for acute cystitis in adult women. However, local guidelines advice that immediate antibiotic treatment was not considered necessary for women with uncomplicated lower UTI. Antimicrobial resistance have complicated treatment of UTI worldwide.